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Wednesday October 2, 2013 MYT 12:00:00 AM
Wednesday October 2, 2013 MYT 8:42:50 AM
by dr kok meng sum
A patient’s safety and comfort is an anaesthesiologist’s highest priority. — Filepic/REUTERS
In conjunction with National Anaesthesia Day on Oct 12, Fit4life will be publishing a series of articles to increase awareness of the role of anaesthesia in healthcare. This first feature offers a general overview of the specialty.
OCTOBER 16, 1846 marked the first successful demonstration of painless surgery, a pathbreaking moment and the birth of a specialty in medicine – anaesthesia.
Anaesthesiologists are highly trained medical doctors, specialists in a very exclusive field of medicine. Many may not realise that we are now living in the blessed days of anaesthesia. Surgery sans pain, pain-free childbirth and safe surgeries are all possible due to anaesthesia.
Imagine being strapped down for surgery with nothing but alcohol, something deemed inhumane in this era, but was thought to be part of the natural surgical experience just centuries ago.
Anaesthesia is derived from the Greek word “an-aisthesis”, meaning “without feeling”, which literally translates to “loss of sensation”.
Administering anaesthesia is just one of the anaesthesiologist’s many responsibilities. The scope of anaesthetic services also include that of perioperative physician, acute and chronic pain control, intensive care (ICU), interventional cardiology and radiology, psychiatry (electroconvulsive therapy), transfusion and blood conservation and also roles in other fields like neonatal/geriatric/obstetric/paediatric specialties.
Hence, it is not surprising that an anaesthesiologist is an integral team member of almost 90% of hospital departments.
One of the faces of an anaesthesiologist presented to you may be in the form of a perioperative physician in the Anaesthetic Clinic.
In 2012, a total of 76,686 patients were assessed in the Anaesthetic Clinic prior to elective surgery in Ministry of Health hospitals, an increase of 23.5% when compared to the year before. This number represents 50% of patients who underwent elective surgery.
In simple terms, the Anaesthetic Clinic is a place where health checks take place prior to anaesthesia. Patients are not anaesthetised here, at least not yet, but rather it is a place to prepare for anaesthesia in the form of a consultation. What is done here is known as preoperative or preanaesthetic assessment, which is as important as the anaesthesia itself.
The preoperative appointment serves a dual purpose. As anaesthesiologists are pioneers in patient safety, the main purpose of this review in the Anaesthetic Clinic is to ensure a safe anaesthesia journey for all patients.
A preoperative check includes a medical checkup and laboratory investigations, to be reviewed prior to surgery, to assess physical status, functional reserves and fitness for surgery.
It also serves as a place to explore the best options for safe anaesthesia, in addition to understanding risks and benefits of the chosen methods of anaesthesia prior to giving written consent.
The plan for anaesthesia depends on:
Other issues that will also be discussed in the session include:
Every patient should undergo an Anaesthetic Clinic appointment when feasible.
But, what about minor surgery that requires anaesthesia, you may ask? Unfortunately, the risk of anaesthesia remains the same even if the surgery is minor.
Anaesthesia today is a very safe procedure, perhaps safer than going for a car ride. It is, however, not without risks.
A major contributor to risks of anaesthesia is derived from preexisting health problems such as heart disease and diabetes, while lifestyle factors such as smoking and obesity, and inherent anaesthesia and surgical risks, play their parts too.
Minor side effects and complications are more common, but less devastating. This includes nausea and vomiting, sore throat and dizziness.
Serious or life-threatening problems are fortunately very rare, although it is this category that presents to anaesthesiologists as “troublemakers”. Examples include awareness under anaesthesia, life threatening allergic reaction, stroke and heart attack.
Preparing for surgery may be stressful, but a patient can play his or her part to reduce the risks of anaesthesia.
Take the example of the advice “to fast after midnight before surgery”. The reason for adequate fasting before anaesthesia is to reduce the risk of vomiting and to prevent aspiration (stomach contents entering lungs while falling asleep), which could lead to serious lung problems and even death.
Even chewing gum or tobacco products will increase the juices in the stomach, which can be as dangerous if aspirated, and therefore a no-no!
Fasting means nothing should pass through the lips. There are of course exceptions, where specific medications should be taken with sips, and only sips of water, as will be instructed by your anaesthesiologist.
Smoking should be avoided too, preferably six weeks prior to anaesthesia. Cessation of smoking can improve the amount of oxygen in the blood, reduce irritability of the lungs, and improve safety, healing and health.
Besides meeting the anaesthesiologist in the Anaesthetic Clinic, a patient may also encounter them in the wards and the operating theatre for a similar assessment and discussion.
Nearly everyone has heard, or perhaps even have stories to tell, about anaesthesia. – some myths, some facts, and some just plain old wives tales.
Which is which, you may ask? Have a chat with your anaesthesiologist; of the worries, the questions, the fears, and of anything that you may be concerned about, and they will try to address the issues.
You may not see an anaesthesiologist as often as you may like, but they are there to watch over you and care for you before, during, and after surgery. A patient’s safety and comfort is an anaesthesiologist’s highest priority.
National Anaesthesia Day
Interested to learn more about anaesthesia? We invite you to unveil an anaesthesiologist’s mask during this National Anaesthesia Day celebration.
This year, “Your LIFE... We CARE!!!” has been chosen as the main theme for the celebrations, and it refers to our commitment to ensure that your life is in safe hands under our care.
Listed below is a snapshot of our activities:
Oct 12, 2013 - Taman Tasik Titiwangsa
1. Walk Treasure Hunt – Registration form can be downloaded from www.msa.net.my.
2. Save a life today by learning about basic life support with hands-on cardiopulmonary resuscitation (CPR) session.
3. Video shows and exhibitions.
4. Free medical check-up.
5. Blood donation drive and organ donation pledge.
Hospital Kuala Lumpur events
1. Exhibitions at the main foyer of Hospital Kuala Lumpur (Oct 21-25, 2013)
2. Health talks on Oct 25, 2013 – Main Auditorium, Hospital Kuala Lumpur
See you there!
Dr Kok Meng Sum is from the Department of Anaesthesiology & Intensive Care, Hospital Kuala Lumpur. October 16th was observed as World Anaesthesia Day in 1996, 150 years after the specialty was founded, and it is now celebrated annually worldwide. Despite playing a vital role in the healthcare system, contributions made by anaesthesiologists are not often recognised by the public.
This lack of awareness has spurred the Malaysian Society of Anaesthesiologists and the Department of Anaesthesiology & Intensive Care, Hospital Kuala Lumpur, to launch National Anaesthesia Day, which aims to increase awareness about the existence of anaesthesiologists, their mutifaceted roles and responsibilities, and how they contribute towards patient care.
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Health, world anaesthesia day, part 1
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